Individual provider Active NPI

Patrick Smith

  • Sports Physical Therapist
  • Mansfield, PA
National Provider Identifier
1922475631
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
License
PT024747 Issued in PA
Practice address
285 S Main St
Mansfield, PA 16933-1512
Phone
(570) 662-1400
NPI assigned
Aug 28, 2015
Last updated
Aug 28, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X PT024747 PA Primary

Addresses

Primary practice location

285 S Main St
Mansfield, PA 16933-1512

Mailing address

11 1/2 N Main St Apt a
Mansfield, PA 16933-1403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170125001028 PA Practitioner - Physical Therapist in Private Practice 5597053694 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabclinics (SPT), Inc. Sports Current Accepting new patients
Elite Therapy PC Sports CurrentSince Aug 8, 2016 Accepting new patients
Rehabclinics (SPT), Inc. CurrentSince Jun 1, 2020 Accepting new patients
Rehabclinics SPT, Inc. CurrentSince Jun 1, 2020 Accepting new patients

Locations

285 S Main St
Mansfield, PA 16933
Phone (570) 662-1400

4714 Gettysburg Rd
Mechanicsburg, PA 17055
Phone (888) 735-6332

604 Commons Dr
Ste D3
Oxford, PA 19363
Phone (610) 932-3619

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1922475631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 1/2 N MAIN ST APT A",
            "city": "MANSFIELD",
            "state": "PA",
            "postal_code": "169331403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 S MAIN ST",
            "city": "MANSFIELD",
            "state": "PA",
            "postal_code": "169331512",
            "telephone_number": "570-662-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PATRICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-28",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "PA",
            "license": "PT024747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.